Urology Journal

ISSN: 1735-1308

Instant 2021

Evaluation of the Clinical Effects of Abobotolinum Toxin A (Dysport) Injection in the Treatment of Neurogenic Lower Urinary Tract Dysfunction Dysport injection in bladder and urethra

Urology Journal, , 23 February 2021 , Page 6720
https://doi.org/10.22037/uj.v18i.6720

Abstract

Purpose: Neurogenic lower urinary tract dysfunction (NLUTD) is one of the most challenging problems in urology. In recent years, Onabotulinum toxin A (Botox) is considered a second-line treatment in these patients. This study aimed to evaluate the clinical effects of Abobotolinum toxin A (Dysport) into the bladder and urethra.


Materials and Methods: We classified our patients with NLUTD into three groups: neurogenic detrusor overactivity (group 1), detrusor sphincter dyssynergia (group 2), and patients with both symptoms (group 3). The severity of the patient’s symptoms was assessed using the Urinary Distress Inventory- Short form (UDI-6), urodynamic study, and post-void residual urine (PVR) at baseline. After injection of Dysport, the patients evaluated by the change in UDI-6 score, PVR, and the patient’s general satisfaction. In group 1, 500-900 U diluted Dysport injected intra-vesical. If associated with detrusor sphincter dyssynergia (group 3), 100 U diluted Dysport injected peri-urethral. In group 2, only 100 U diluted Dysport injected peri-urethral.


Results: Data from 52 women with NLUTD were analyzed. The mean age was 51.3 ± 21.6 years. The prevalence of detrusor overactivity and the value of Q max was more in group 1. However, the amount of PVR was more in groups 2 and 3. The overall success rate was acceptable in all three groups. In addition, there were significant improvements in UDI-6 parameters.


Conclusion: Peri-urethral injection of Abobotolinum toxin A is effective and safe. However, the selection of the patients and the dose of toxin needs more studies.

Keywords:
  • Abobotolinum toxin A, Neurogenic, Urethra, Voiding dysfunction

How to Cite

Sharifiaghdas, F., Taheri, M., Borumandnia, N., & Sheikhi, Z. (2021). Evaluation of the Clinical Effects of Abobotolinum Toxin A (Dysport) Injection in the Treatment of Neurogenic Lower Urinary Tract Dysfunction: Dysport injection in bladder and urethra. Urology Journal, 18, 6720. https://doi.org/10.22037/uj.v18i.6720

References

REFERENCES
1. Przydacz M, Denys P, Corcos J. What do we know about neurogenic bladder prevalence and management in developing countries and emerging regions of the world? Annals of Physical and Rehabilitation Medicine. 2017;60:341-6.
2. Liao L. Evaluation and Management of Neurogenic Bladder: What Is New in China? Int J Mol Sci. 2015;16:18580-600.
3. Seth JH, Dowson C, Khan MS, et al. Botulinum toxin-A for the treatment of overactive bladder: UK contributions. Journal of clinical urology. 2013;6:77-83.
4. Schurch B, Hauri D, Rodic B, Curt A, Meyer M, Rossier AB. Botulinum-A toxin as a treatment of detrusor-sphincter dyssynergia: a prospective study in 24 spinal cord injury patients. J Urol. 1996;155:1023-9.
5. Dykstra DD, Sidi AA, Scott AB, Pagel JM, Goldish GD. Effects of botulinum A toxin on detrusor-sphincter dyssynergia in spinal cord injury patients. The Journal of urology. 1988;139:919-22.
6. Steinhardt GF, Naseer S, Cruz OA. Botulinum toxin: novel treatment for dramatic urethral dilatation associated with dysfunctional voiding. The Journal of urology. 1997;158:190-1.
7. Jiang YH, Wang CC, Kuo HC. OnabotulinumtoxinA Urethral Sphincter Injection as Treatment for Non-neurogenic Voiding Dysfunction - A Randomized, Double-Blind, Placebo-Controlled Study. Sci Rep. 2016;6:38905.
8. Soler JM, Previnaire JG, Hadiji N. Predictors of outcome for urethral injection of botulinum toxin to treat detrusor sphincter dyssynergia in men with spinal cord injury. Spinal Cord. 2016;54:452-6.
9. Hervé F, Viaene A, Everaert K. OnabotulinumtoxinA injections in detrusor facilitate self-catheterisation in a patient with paraplegia and bladder outlet dyssynergia. BMJ case reports. 2017;2017:bcr2016218429.
10. Uebersax JS, Wyman JF, Shumaker SA, McClish DK. Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Neurourology and urodynamics. 1995;14:131-9.
11. Kuo HC. Therapeutic outcome and quality of life between urethral and detrusor botulinum toxin treatment for patients with spinal cord lesions and detrusor sphincter dyssynergia. International journal of clinical practice. 2013;67:1044-9.
12. Schurch B, Yasuda K, Rossier AB. Detrusor bladder neck dyssynergia revisited. The Journal of urology. 1994;152:2066-70.
13. Chancellor MB, Fowler CJ, Apostolidis A, et al. Drug Insight: biological effects of botulinum toxin A in the lower urinary tract. Nature clinical practice Urology. 2008;5:319-28.
14. C. de Groat MF, M. Yoshiyama, S. Smerin, C. Tai, MB Chancellor, N. Yoshimura, JR Roppolo, W. Neural control of the urethra. Scandinavian Journal of Urology and Nephrology. 2001;35:35-43.
15. Kakizaki H, Fraser M, De Groat W. Reflex pathways controlling urethral striated and smooth muscle function in the male rat. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 1997;272:R1647-R56.
16. Shafik A. Study of the effect of vesical filling and voiding on ureterovesical junctions and internal urethral meatus: the filling and meato‐vesico‐ureteral reflexes. International journal of urology. 1998;5:449-53.
17. Blaivas J. Pathophysiology of lower urinary tract dysfunction. The Urologic clinics of North America. 1985;12:215-24.
18. Elbadawi A, Schenk EA. A new theory of the innervation of bladder musculature. Part 4. Innervation of the vesicourethral junction and external urethral sphincter. The Journal of urology. 1974;111:613-5.
19. Caremel R, Courtois F, Charvier K, Ruffion A, Journel NM. Side effects of intradetrusor botulinum toxin injections on ejaculation and fertility in men with spinal cord injury: preliminary findings. BJU international. 2012;109:1698-702.
20. Siegel S, Noblett K, Mangel J, et al. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6‐months in subjects with mild symptoms of overactive bladder. Neurourology and urodynamics. 2015;34:224-30.
21. Kuo H-C. Recovery of detrusor function after urethral botulinum A toxin injection in patients with idiopathic low detrusor contractility and voiding dysfunction. Urology. 2007;69:57-61.
22. Kuo HC. Satisfaction with urethral injection of botulinum toxin A for detrusor sphincter dyssynergia in patients with spinal cord lesion. Neurourology and Urodynamics: Official Journal of the International Continence Society. 2008;27:793-6.
23. Liao Y-M, Kuo H-C. Causes of failed urethral botulinum toxin A treatment for emptying failure. Urology. 2007;70:763-6.
24. Franco I, Landau-Dyer L, Isom-Batz G, Collett T, Reda EF. The use of botulinum toxin A injection for the management of external sphincter dyssynergia in neurologically normal children. The Journal of urology. 2007;178:1775-80.
25. Emami M, Shadpour P, Kashi AH, Choopani M, Zeighami M. Abobotulinum - a toxin injection in patients with refractory idiopathic detrusor overactivity: injections in detrusor, trigone and bladder neck or prostatic urethra, versus detrusor - only injections. Int Braz J Urol. 2017;43:1122-8.
26. Liao YM, Kuo HC. Causes of failed urethral botulinum toxin A treatment for emptying failure. Urology. 2007;70:763-6.
  • Abstract Viewed: 0 times
  • Just Accepted/6720 Downloaded: 0 times

Download Statastics

In case of persistent problems in registration, primary uploading of a submission or uploading of a revision, please send us the submission files on the journal email at:

urologyjournal@sbmu.ac.ir

and please attach the screenshot of the error or problem you encountered in uploading.

 

Make a Submission
Information
Keywords